Katja Ovaskainen1,2, Riitta Ojala3, Kati Tihtonen4, Mika Gissler5,6, Tiina Luukkaala7,8, Outi Tammela3. 1. Department of Neonatology, Tampere University Hospital, Tampere, Finland. katja.ovaskainen@pshp.fi. 2. School of Medicine Doctoral Programme, University of Tampere, Tampere, Finland. katja.ovaskainen@pshp.fi. 3. Department of Neonatology, Tampere University Hospital, Tampere, Finland. 4. Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland. 5. National Institute for Health and Welfare, Helsinki, Finland. 6. Nordic School of Public Health, Gothenburg, Sweden. 7. Tampere University Hospital, Research, Development and Innovation Center, Tampere, Finland. 8. Tampere University, Health Sciences, Faculty of Social Sciences, Tampere, Finland.
Abstract
OBJECTIVE: To evaluate trends and perinatal outcomes of planned home deliveries in Finland. STUDY DESIGN: All infants born in 1996-2013, excluding those born preterm, by operative delivery, and without information on birth mode or gestational age, were studied. The study group included 170 infants born at home as planned, 720,047 infants born at hospital were controls. RESULT: The rate of planned home deliveries increased from 8.3 to 39.4 per 100,000. In the study group 63%, containing two perinatal deaths, were not low-risk pregnancies according to national guidelines. The rate of hypothermia, asphyxia, and need of invasive ventilation was increased in low-risk home deliveries. One infant had a major congenital malformation. Maternal outcomes were favorable. CONCLUSION: The rate of planned home deliveries increased. Guidelines for low-risk deliveries were not followed in a majority of cases, including two perinatal deaths. Even in low-risk home deliveries, the neonatal morbidity appeared to be increased.
OBJECTIVE: To evaluate trends and perinatal outcomes of planned home deliveries in Finland. STUDY DESIGN: All infants born in 1996-2013, excluding those born preterm, by operative delivery, and without information on birth mode or gestational age, were studied. The study group included 170 infants born at home as planned, 720,047 infants born at hospital were controls. RESULT: The rate of planned home deliveries increased from 8.3 to 39.4 per 100,000. In the study group 63%, containing two perinatal deaths, were not low-risk pregnancies according to national guidelines. The rate of hypothermia, asphyxia, and need of invasive ventilation was increased in low-risk home deliveries. One infant had a major congenital malformation. Maternal outcomes were favorable. CONCLUSION: The rate of planned home deliveries increased. Guidelines for low-risk deliveries were not followed in a majority of cases, including two perinatal deaths. Even in low-risk home deliveries, the neonatal morbidity appeared to be increased.
Authors: Amos Grünebaum; Laurence B McCullough; Robert L Brent; Birgit Arabin; Malcolm I Levene; Frank A Chervenak Journal: Am J Obstet Gynecol Date: 2014-10-15 Impact factor: 8.661